Estimating Direct Cost for Hypertension Management in Urban Primary Health Facilities in Bobo-Dioulasso, Burkina Faso: A Patient-Level Analysi

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Résumé

ntroduction: Hypertension is among the top 10 reasons for visiting primary health care centres (PHCCs) in Burkina Faso. Using a patient-level analysis, this study estimated the direct cost for hypertension management at outpatient care, in urban PHCCs in Bobo-Dioulasso, in the context of a universal health coverage policy development in the country. Methods: This was a cross-sectional study, using an adapted form of the “Costs for Patients Questionnaire” (CoPaQ) that includes different components for direct cost estimations. A sample of 380 hypertensive adults were interviewed from January to February 2022, at 20 public PHCCs in Bobo-Dioulasso. Results: Per patient-year, the means [95% CI] in income and direct cost were 786 947 CFA (USD 1418.3) [694 200 (USD 1251.1) - 879 695 (USD 1585.4)] and 78 623 FCFA (USD 141.3) [68 766 (124.0) - 88 480 (159.5)], respectively. Of the annual total direct cost, 47.5%, 18.5%, 16.3% and 13.5% were spent on medication, medical visits, hospitalisations and paraclinical tests, respectively. Only two patients (0.5%) were enrolled in insurance policy; and uncontrolled hypertension frequency was 72.1% (95% CI: 67.3-76.6). Conclusion: The average direct cost per patient-year of managing hypertension exceeded one-tenth of the patient's annual income, equivalent to more than one-fifth of the country's guaranteed minimum wage, which is a significant financial burden for many people. This study should be followed by cost-effectiveness analyses and community engagement building for hypertension control at small-scale piloting in Bobo-Dioulasso, then broad-based in the country.

Mots-clés

Hypertension, Direct Cost, Income, Primary Health Care, Bobo-Dioulasso, Burkina Faso